title: Pulmonary involvement in pleural tuberculosis: how often does it mean disease activity?
abstract: OBJECTIVE
  To evaluate in chest X-rays and high-resolution computed tomographies of patients with pleural tuberculosis, the incidence of parenchymal and mediastinal lung lesions suggestive of active disease.
  
  
  METHODS
  Prospective study (2008-2009) evaluating the radiographic and tomographic abnormalities of 88 HIV-negative patients with pleural tuberculosis (unilateral effusion). The images were reviewed by 3 independent specialists, and the observed changes were classified according to previously established criteria: presence or absence of signs suggestive of disease activity, and nonspecific findings.
  
  
  RESULTS
  Abnormal changes were observed in chest X-rays of 22 (25%) patients and in the computed tomography of 55 (63%). Images compatible with active pulmonary tuberculosis were detected by radiography in 9 (10%) patients and by tomography in 38 (43%). Only 4 (4.5%) patients had tomography images suggestive of residual disease.
  
  
  CONCLUSIONS
  The present study demonstrates that pulmonary involvement is quite common in pleural tuberculosis. This finding is mainly observed in high-resolution computed tomography and has important epidemiological implications, since patients with pleural tuberculosis are significant sources of infection and disease dissemination.
authors.affiliation: Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, Brazil.
authors.forename: Márcia
authors.initials: M
authors.lastname: Seiscento
authors.forename: Francisco S
authors.initials: FS
authors.lastname: Vargas
authors.forename: Sidney
authors.initials: S
authors.lastname: Bombarda
authors.forename: Roberta K B
authors.initials: RK
authors.lastname: Sales
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Terra
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Uezumi
authors.forename: Lisete R
authors.initials: LR
authors.lastname: Teixeira
authors.forename: Leila
authors.initials: L
authors.lastname: Antonangelo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014396:Tuberculosis, Pleural / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult